Am Fam Physician. 2025;111(1):90-91
An audio version of this AFP Practice Guideline is available on the AAFP audio app.
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Physical therapy appears to improve pain and function in hip osteoarthritis but may be no better than unsupervised exercise after THA.
• NSAIDs consistently reduce pain from hip osteoarthritis.
• Although intra-articular corticosteroid injections improve pain and function for at least 4 months, intra-articular hyaluronic acid injections have no benefit.
• For THA, perioperative tranexamic acid is strongly recommended to reduce anemia.
From the AFP Editors
Osteoarthritis of the hip affects 1 in 14 adults and accounts for 6% of physician clinic visits for osteoarthritis. Patients with hip and knee osteoarthritis have 20% excess mortality compared with age-matched controls. The American Academy of Orthopaedic Surgeons has published guidelines for management of hip osteoarthritis.
CONSERVATIVE TREATMENT
Physical Therapy
The American Academy of Orthopaedic Surgeons moderately recommends physical therapy as a treatment for mild to moderate hip osteoarthritis. Approximately one-half of studies demonstrated significant improvement in pain and function over control groups, but no studies suggested physical therapy worsened outcomes. Most studies only looked at a single component of physical therapy, and many failed to stratify patients by severity of arthritis.
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